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Brooks Memorial to retain dialysis program, for now - Buffalo Business First PDF Print

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Brooks Memorial Hospital is backtracking on a plan to sell the dialysis center within its Dunkirk hospital.

The hospital this week withdrew a certificate-of-need application to sell the 14-station center to University Dialysis Center, a subsidiary of Dialysis Clinic Inc. (DCI), the nation’s largest non-profit dialysis provider.

The initial plan, filed last fall, called for University Dialysis to take over chronic renal dialysis and to add home peritoneal dialysis training and support.

At the time, hospital CEO J. Gary Rhodes told Business First the hospital could no longer afford to operate the program.

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Modified 2/1 Sunitinib Schedule May Be Safer in Renal Cell Carcinoma - Cancer Therapy Advisor PDF Print
July 29, 2015 Modified 2/1 Sunitinib Schedule May Be Safer in Renal Cell Carcinoma - Cancer Therapy Advisor
Patients with metastatic renal cell carcinoma who transitioned to a modified 2/1 schedule of sunitinib experience an improved safety profile.

Patients with metastatic renal cell carcinoma who transitioned to a modified 2/1 schedule of sunitinib experience an improved safety profile compared with that observed during the initial 4/2 schedule, a new study published online ahead of print in the journal Annals of Oncology has shown.

Patients receiving first-line sunitinib to treat metastatic renal cell carcinoma typically receive 4 weeks of treatment followed by 2 weeks off, but that schedule is often associated with relevant toxicities and related dose reductions. Therefore, researchers sought to evaluate the safety profile of an alternative schedule, 2 weeks on and 1 week off.

For the study, researchers retrospectively analyzed data from 249 patients with metastatic renal cell carcinoma who received first-line treatment with sunitinib.

Of those, 208 initiated sunitinib on the 4/2 schedule and then transitioned to the 2/1 schedule due to toxicity and 41 patients started with sunitinib on the 2/1 schedule.

Researchers compared the safety of those patients with 211 patients treated with the 4/2 schedule at another institution.

Results showed that among those who started on the 4/2 schedule and switched to the 2/1 schedule, the overall incidence of grade 3 or higher toxicities was significantly reduced from 45.7% to 8.2% (P<0.001). 

RELATED: Standard for Detecting Occult Bone Mets in Renal Cell Carcinoma May Not Be Optimal

Researchers found that the incidence of fatigue, hypertension, hand-foot syndrome, and thrombocytopenia were less common with the 2/1 schedule.

In regard to efficacy, median progression-free survival was 30.2 months in the group that switched schedules, 10.4 months in the 2/1 group, and 9.7 months in the 4/2 group.

Reference

  1. Bracarda S, Iacovelli R, Boni L, et al. Sunitinib administered on 2/1 schedule in patients with metastatic renal cell carcinoma: the RAINBOW analysis. Ann Oncol. 2015. [epub ahead of print]. doi: 10.1093/annonc/mdv315.

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Erectile Function Worsens In Most Men After Prostate Biopsy - Renal and Urology News PDF Print
July 29, 2015 Results of a prospective study have implications for patient counseling.
Results of a prospective study have implications for patient counseling.

Prostate biopsies may result in a decline in erectile function, according to researchers.

In a prospective study, most men who underwent a transrectal ultrasonography (TRUS)-guided prostate biopsy experienced a significant decrease in International Index of Erectile Function-5 (IIEF-5) score, independent of age, cancer diagnosis, and prior biopsy status.

Writing in a paper published in BJU International (2015;116:190-195), investigators concluded that men who undergo TRUS-guided prostate biopsy should be counseled on all of the potential side effects and complications of the procedure.

The study, led by Katie S. Murray, MD, of the University of Kansas Medical Center in Kansas City, enrolled 220 men with a mean age of 64.1 years and a PSA level of 6.7 ng/dL. At presentation, 38.6% reported no erectile dysfunction (ED), 22.3% mild ED, 15.5% mild-to-moderate ED, 10% moderate ED, and 13.6% severe ED. Patients were sent IIEF-5 follow-up questionnaires at 1, 4, and 12 weeks. The number of patients who returned follow-up questionnaires at each follow-up time-point differed (163, 126, and 103 at 1, 4, and 12 weeks, respectively). This led to different baseline mean IIEF-5 scores at each time-point.

At 1 week post-biopsy, the mean IIEF-5 score was significantly lower than it was at baseline (15.5 vs. 18.2). The mean score remained significantly lower compared with baseline at 4 and 12 weeks (17.3 vs. 18.4 and 16.9 vs. 18.4, respectively).

“ED, acute or sub-acute, should be discussed with the patients before biopsy because biopsy has been shown to affect erections in men at many time-points after biopsy,” the authors wrote.

Study results also show that men aged 60 years and older are predisposed to worse erectile function after biopsy, so prostate biopsy should be used even more cautiously in this group, and physician-to-patient counseling “should include this potential outcome in more detail.”

The study also found that patients who had a final prostate cancerdiagnosis were more likely to have a decline in IIEF-5 after biopsy. The precise mechanism of this decline in these patients is most likely multifactorial, the investigators stated. Psychogenic causes, fear of results, anxiety related to biopsy, and even anatomical considerations such as nerve damage and hematoma could potentially have a role, they noted.

In an accompanying editorial (pp. 164-169), Brian T. Helfand, MD, of the North Shore University Health System in Chicago and the University of Chicago, noted that the study by Dr. Murray and her colleagues supports the findings of some retrospective studies but contradicts the findings of others. In a previous study, Dr. Helfand and colleagues demonstrated that a PCa diagnosis is associated with an increased risk of ED after a prostate biopsy, similar to what Dr. Murray and colleagues found.

When the findings of Dr. Murray's team are considered in the context of previous studies on this topic, Dr. Helfand noted, it appears that patients should be counseled on the possibility of short-term changes in erectile function after a prostate biopsy. It also should be emphasized, however, that long-term ED might not be related to the biopsy procedure itself but rather to other factors, included advanced age, psychological stress, and/or PCa diagnosis, according to Dr. Helfand.

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Kidney Dialysis - Will It Ever Be Affordable to the Ordinary Rwandan - AllAfrica.com PDF Print

Kidney dialysis is life-saving. Without it, patients whose kidneys no longer function well would die relatively quick due to electrolyte abnormalities and the buildup of toxins in the blood stream.

Kidney failure may occur from an acute situation that injures the kidneys or from chronic diseases that gradually cause the kidneys to stop functioning and it is possible to lose 90% of kidney function without experiencing any symptoms or problems, according to medical experts.

Dialysis is an artificial method of filtering the blood and is used when someone's kidneys have failed or are close to failing. Many people with late-stage kidney disease must go on dialysis either permanently or until a donor kidney for transplantation can be found.

Patients may live for several years with dialysis but other underlying and associated illnesses often are the cause of death.

The kidneys have the ability to monitor the amount of body fluid, the concentrations of electrolytes like sodium and potassium, and the acid-base balance of the body. They filter waste products of body metabolism, like urea from protein metabolism and uric acid from DNA breakdown.

"Often, for patients with chronic kidney disease due to diabetes, high blood pressure, or another related medical condition; the patient's medical care team most likely monitors kidney function as part of the patient's routine long-term medical care plan," said Dr Richard Cyamatare, a nephrologist and head of hemo-dialysis department at CHUK hospital.

Dr Cyamatare added that kidney function may return to normal, especially if it is due to an acute obstruction and that obstruction is relieved but severe damage of the kidneys may lead to chronic kidney disease where dialysis intervene as a substitute for many of the normal duties of the kidneys.

Although the statistics are not up-to-date, in Rwanda, Kidney failure is increasing and it is a big burden because the treatment is very expensive that no health insurance service provider can support except RSSB and FARG.

"The cost of dialysis is too high to be afforded by most of the patients and unfortunately there are no kidney transplant services in the country to rely on. For a patient, a dialysis is done thrice a week and each session costs Frw 120,000 and this amount to more than Frw 10 million per month.

"The cost is high and very few patients can afford it. Since September, 2014, we have received a total of 47 patients but because of the high cost of the treatment, many have left to die at their homes," Dr Cyamatare said. Kamariza Herniette , 22, has chronic kidney disease following her symptoms of hypertension. Ensured by FARG, she has been on dialysis at CHUK Hospital since February and will soon go abroad for a kidney transplant after being donated a kidney by her elder sister. She said that her condition has been improving since she was put on dialysis treatment but calls upon government to support other patients who can't afford dialysis. Prevention Dr Cyamatare advises the public to for routine medical tests because the earlier the treatment, the more the chances of healing. He warned people against opting for unprofessional medication, adding that many kidney problems result from wrong medicaments. "Chronic diseases such as hypertension (high blood pressure) and diabetes are devastating because of the damage they can do to kidneys and other organs. Lifelong diligence is important to keep blood sugar and blood pressure within normal limits. Specific treatments depend upon the underlying diseases," Dr Cyamatare said. "Once kidney failure is present, the goal is to prevent further deterioration of renal function. If ignored, the kidneys will progress to complete failure but if underlying illnesses are addressed and treated aggressively, kidney function can be preserved, though not always improved," he added. "Therefore it's important to keep one's weight in check through a healthy diet and regular exercise regimen, as both of these are known to prevent diabetes, heart disease and other conditions associated with chronic kidney disease."

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New report sheds light on the renal cell carcinoma pipeline review H1 2015 - WhaTech PDF Print

New report sheds light on the renal cell carcinoma pipeline review H1 2015

The report enhances decision making capabilities and help to create effective counter strategies to gain competitive advantage. It strengthens R&D pipelines by identifying new targets and MOAs to produce first-in-class and best-in-class products.

ACCESS REPORT : Renal Cell Carcinoma - Pipeline Review, H1 2015

Summary ‘Renal Cell Carcinoma - Pipeline Review, H1 2015’, provides an overview of the Renal Cell Carcinoma’s therapeutic pipeline. This report provides comprehensive information on the therapeutic development for Renal Cell Carcinoma, complete with comparative analysis at various stages, therapeutics assessment by drug target, mechanism of action (MoA), route of administration (RoA) and molecule type, along with latest updates, and featured news and press releases. It also reviews key players involved in the therapeutic development for Renal Cell Carcinoma and special features on late-stage and discontinued projects. This report features investigational drugs from across globe covering over 20 therapy areas and nearly 3,000 indications. The report is built using data and information sourced from Global Markets Direct’s proprietary databases, Company/University websites, SEC filings, investor presentations and featured press releases from company/university sites and industry-specific third party sources, put together by Global Markets Direct’s team. Drug profiles/records featured in the report undergoes periodic updation following a stringent set of processes that ensures that all the profiles are updated with the latest set of information. Additionally, processes including live news & deals tracking, browser based alert-box and clinical trials registries tracking ensure that the most recent developments are captured on a real time basis. Scope - The report provides a snapshot of the global therapeutic landscape of Renal Cell Carcinoma
- The report reviews key pipeline products under drug profile section which includes, product description, MoA and R&D brief, licensing and collaboration details & other developmental activities
- The report reviews key players involved in the therapeutics development for Renal Cell Carcinoma and enlists all their major and minor projects
- The report summarizes all the dormant and discontinued pipeline projects
- A review of the Renal Cell Carcinoma products under development by companies and universities/research institutes based on information derived from company and industry-specific sources
- Pipeline products coverage based on various stages of development ranging from pre-registration till discovery and undisclosed stages
- A detailed assessment of monotherapy and combination therapy pipeline projects
- Coverage of the Renal Cell Carcinoma pipeline on the basis of target, MoA, route of administration and molecule type
- Latest news and deals relating related to pipeline products Reasons to Access - Provides strategically significant competitor information, analysis, and insights to formulate effective R&D development strategies
- Identify emerging players with potentially strong product portfolio and create effective counter-strategies to gain competitive advantage
- Develop strategic initiatives by understanding the focus areas of leading companies
- Identify and understand important and diverse types of therapeutics under development for Renal Cell Carcinoma
- Plan mergers and acquisitions effectively by identifying key players of the most promising pipeline
- Devise corrective measures for pipeline projects by understanding Renal Cell Carcinoma pipeline depth and focus of Indication therapeutics
- Develop and design in-licensing and out-licensing strategies by identifying prospective partners with the most attractive projects to enhance and expand business potential and scope
- Modify the therapeutic portfolio by identifying discontinued projects and understanding the factors that drove them from pipeline VIEW REPORT TOC

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